Background We compared the outcome of early oral feeding (EOF) compared to traditional oral feeding (TOF) in patients undergoing elective small intestine anastomosis.
Materials and Methods This randomized single-blinded controlled trial was performed on 108 patients who underwent small intestine anastomosis. The patients were randomly assigned to schedule EOF (with starting oral feeding on the first day after surgery and complete return of the Gag reflex) or TOF (with delaying oral feeding till the first passage of flatus and bowel movement). We compared the overall prevalence of postoperative complication, length of hospital stays and outcome of surgery in two groups.
Results The time to first passage of stool was shorter in EOF group than in TOF group (3.2 ± 0.59 days versus 3.6 ± 0.66 days (p = 0.006). The mean length of hospital stay in EOF group was also shorter than in TOF group (3.8 ± 1.06 days versus 6.3 ± 1.0 days, p = 0.001). The length of hospital stays shorter than 4 days was found in 75.9% of patients in EOF group and 11.1% of those patients in TOF group (p < 0.001).
Conclusion The use of EOF in patients undergoing small intestine anastomosis can shorten time to first passage of stool as well as reduce the length of hospital stay.
Bauer JJ, Gelernt IM, Salky BA, Kreel I. Is routine postoperative nasogastric decompression really necessary? Ann Surg 1985; 201:233–6.
Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991;1(3):144–50.
Meltvedt Jr R, Knecht B, Gibbons G, Stahler C, Stojowski A, Johansen K. Is nasogastric suction necessary after elective colon resection? Am J Surg 1985;149(5):620–2.
Petrelli NJ, Stulc JP, Rodriguez-Bigas M, Blumenson L. Nasogastric decompression following elective colorectal surgery: a prospective randomized study. Am Surg 1993;59(10):632–5.
DiFronzo LA, Cymerman J, O’Connell TX. Factors affecting early postoperative feeding following elective open colon resection. Arch Surg 1999; 134:941–6.
Argov S, Goldstein I, Barzilai A. Is routine use of the nasogastric tube justified in upper abdominal surgery? Am J Surg 1980;139(6):849–50
Meguid MM, Campos AC, Hammond WG. Nutritional support in surgical practice: Part II. Am J Surg 1990;159(4):427–43.
Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV, Morgenstein Wagner TB, et al. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 1992;216(2):172–83
Mandell SP, Gibran NS. Early Enteral Nutrition for Burn Injury. Adv Wound Care (New Rochelle). 2014 Jan 1;3(1):64-70
Vicic VK, Radman M, Kovacic V. Early initiation of enteral nutrition improves outcomes in burn disease. Asia Pac J Clin Nutr. 2013;22(4):543-7.
Osland E1, Yunus RM, Khan S, Memon MA. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. JPEN J Parenter Enteral Nutr. 2011 Jul;35(4):473-87. doi: 10.1177/0148607110385698. Epub 2011 May 31.
Thapa PB1, Nagarkoti K, Lama T, Maharjan DK, Tuladhar M. Early enteral feeding in intestinal anastomosis. J Nepal Health Res Counc. 2011 Apr;9(1):1-5.
Böhm B1, Haase O, Hofmann H, Heine G, Junghans T, Müller JM. Tolerance of early oral feeding after operations of the lower gastrointestinal tract. Chirurg. 2000 Aug;71(8):955-62.
Zhou Tong, Wu Xiao-Ting, Zhou Ye-Jiang, Huang Xiong, Fan Wei, Li Yue-Chun.
Early removing gastrointestinal decompression and early oral feeding improve patients’ rehabilitation after colorectostomy. World J Gasteroenterol 2006; 12:2459–63.
Hjort Jakobsen D, Sonne E, Basse L. Convalescence after colonic resection with fast-track versus conventional care. Scand J Surg 2004; 93:24–8.
Reissman P, Teoh TA, Cohen SM,Weiss EG, Nogueras JJ, Wexner SD. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial. Ann Surg 1995:22273–7.
Lewis JS, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus nil by mouth after gastrointestinal surgery: systematic review and meta-analyses of controlled trials. BMJ 2001;323:773–6.
Ozerhan IH, Ersoz N, Onguru O, Ozturk M, Kurt B, Cetiner S. Fascin expression in colorectal carcinomas. Clinics. 2010; 65:157-64, doi: 10.1590/ S1807-59322010000200007.
Gonc¸alves CG, Groth AK, Ferreira M, Matias JE, Coelho JC, Campos AC. Influence of preoperative feeding on the healing of colonic anastomoses in malnourished rats. J Parenter Enteral Nutr. 2009;33:83-9, doi: 10.1177/ 0148607108327047.
Filiz AI, Sucullu I, Kurt Y, Karakas DO, Gulec B, Akin ML. Persistent high postoperative carcinoembryonic antigen in colorectal cancer patients—is it important? Clinics. 2009; 64:287-94, doi: 10.1590/S1807- 59322009000400004.
Demetriades H, Botsios D, Kazantzidou D, Sakkas L, Tsalis K, Manos K, et al. Effect of early postoperative enteral feeding on the healing of colonic anastomosis in rats. Eur Surg Res. 1999;31:57–63, doi: 10.1159/000008621.
Inan A, Sen M, Surgit O, Ergin M, Bozer M. Effects of the histamine H2 receptor antagonist famotidine on the healing of colonic anastomosis in rats. Clinics. 2009; 64:567-70, doi: 10.1590/S1807-59322009000600012.
Schilder JM, Hurteau JA, Look KY, Moore DH, Raff G, Stehman FB, et al. A prospective controlled trial of early postoperative oral intake following major abdominal gynecologic surgery. Gynecol Oncol. 1997; 67:235–40, doi: 10.1006/gyno.1997.4860.
Cheatham ML, Chapman WC, Key SP, Sawyers JL. A metaanalysis of selective versus routine nasogastric decompression after elective laparotomy. Ann. Surg. 1995; 221:469–76, doi: 10.1097/00000658-199505000-00004.